Practice guidelines on the use of esophageal manometry – A GISMAD-SIGE-AIGO medical position statement

Savarino, Edoardo; Bortoli, Nicola de; Bellini, Massimo; Galeazzi, Francesca; Ribolsi, Mentore; Salvador, Renato; Savarino, Vincenzo; Penagini, Roberto

doi:10.1016/j.dld.2016.06.021

Cited by 92 publications

(101 citation statements)

References 134 publications

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“…14,15 The HRM catheter was advanced such that the three distal-most sensors registered an intragastric location. 14,15 The HRM catheter was advanced such that the three distal-most sensors registered an intragastric location.…”

Section: High-resolution Manometrymentioning

confidence: 99%

Fragmented and failed swallows on esophageal high‐resolution manometry associate with abnormal reflux burden better than weak swallows

Rogers

Rengarajan

Ghisa

et al. 2019

Neurogastroenterology Motil

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Background Association between proportions of hypomotile swallows on esophageal high‐resolution manometry (HRM) and esophageal reflux burden remains incompletely understood. We investigated relationships between hypomotility, acid exposure time (AET), and mean nocturnal baseline impedance (MNBI) on ambulatory reflux monitoring. Methods Clinical data, HRM, and ambulatory pH‐impedance studies (performed off acid suppression) from patients with persisting reflux symptoms were reviewed from five international centers. AET (abnormal > 6%) and MNBI (abnormal < 2292 ohms) were extracted from pH‐impedance studies. Distal contractile integral (DCI) designated esophageal peristalsis into normal (DCI > 450 mmHg.cm.s), fragmented (DCI > 450 mmHg.cm.s with breaks > 5 cm), weak (DCI 100‐450 mmHg.cm.s), and failed (DCI < 100 mm mmHg.cm.s) sequences. Univariate and multivariate analyses were performed to identify motor associations of abnormal reflux burden. Key Results Of 351 patients (52.1 ± 0.8 years, 67%F), 29.3% had AET > 6% and 61.8% had MNBI < 2292 ohms. On univariate analysis, both fragmented peristalsis and IEM associated with abnormal AET (P ≤ .01) and MNBI (P ≤ .03); reflux burden was more profound with >70% fragmented as well as ineffective sequences compared to ≤70% for each (P < .05 for each comparison). When weak and failed sequences within IEM were separately analyzed, ≥50% failed sequences predicted abnormal AET (P ≤ .009), and ≥50% weak sequences did not (P = .14). On multivariate regression, ≥50% failed sequences predicted abnormal AET (P = .02), and >70% ineffective sequences trended strongly (P = .069); >70% ineffective sequences predicted abnormal MNBI (P = .046), and >70% fragmented sequences trended strongly (P = .076). Conclusions and Inferences Breaks in esophageal peristaltic integrity seen with fragmented and failed sequences are more relevant to abnormal esophageal acid burden than weak sequences.

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Section: High-resolution Manometrymentioning

confidence: 99%

Fragmented and failed swallows on esophageal high‐resolution manometry associate with abnormal reflux burden better than weak swallows

Rogers

Rengarajan

Ghisa

et al. 2019

Neurogastroenterology Motil

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“…Por tanto, es un reto que los gastroenterólogos y los fellows en gastroenterología estén suficientemente familiarizados con la MAR para su uso apropiado en la práctica clínica, con el fin de lograr un manejo óptimo de los pacientes con desórdenes primarios o secundarios de la motilidad (4,9,10).…”

Section: Indicacionesunclassified

“…ej. : bloqueadores de canales de calcio, nitratos, procinéticos, loperamida, bloqueantes β, opiáceos, anticolinérgicos, entre otros) (1,4,10).…”

Section: Cómo Realizar Un Estudio De Alta Calidadunclassified

“…Una respuesta anormal consiste en una inhibición incompleta (cuando se ven fragmentos de contracción durante el período esperado de inhibición) o contracción subóptima (la secuencia posterior a múltiples degluciones rápidas falla para demostrar un aumento de la contracción del músculo liso). Las múltiples degluciones rápidas de bajo volumen evalúan la reserva peristáltica, mientras que las degluciones de grandes volúmenes identifican un aumento de la resistencia al flujo (4,13).…”

Section: Potenciales Indicacionesunclassified

“…El desarrollo de los catéteres de alta resolución y de un software que realiza los trazados con códigos de color y segmentos de presión ha revolucionado el método de evaluación diagnóstica de los trastornos motores esofági-cos, con grandes ventajas al comparar los resultados con los obtenidos por estudios de manometría convencional (4,5). Esto llevó en pocos años a que la MAR esofágica y la topografía de presión esofágica (EPT) comenzaran a ser utilizadas en el escenario de investigación clínica y la práctica clínica.…”

Section: Introductionunclassified

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Cómo realizar e interpretar una manometría esofágica de alta resolución usando la clasificación de Chicago 3.0

Hani

Bernal

Leguízamo

et al. 2017

Rev. Colomb. Gastroenterol.

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Con la introducción de la manometría esofágica de alta resolución se revelaron patrones no identificados previamente de la función esofágica. De igual forma, este metodo diagnóstico adiciona patrones de presión topográfica de la presión esofágica, lo que lleva al desarrollo de nuevas herramientas para el análisis y clasificación de desórdenes motores esofágicos. En la actualidad la clasificación de Chicago3.0 la herramienta de análisis de los diferentes trastornos motores esofágicos. En Colombia, cada día se ve el crecimiento en la realización de este estudio. El artículo propone hacer una revisión de cómo realizar e interpretar una manometría esofágica de alta resolución y clasificar los diferentes trastornos de la motilidad esofágica según la última actualización de la clasificación de Chicago 3.0.

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Manometric identikit of a functioning and effective fundoplication for gastroesophageal reflux disease in the high‐resolution manometry ERA

Salvador,

Capovilla,

Santangelo

et al. 2024

UEG Journal

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BackgroundThe pathophysiological and clinical value of performing High‐Resolution Manometry (HRM) after laparoscopic fundoplication (LF) for gastroesophageal reflux disease (GERD) is still unclear and debated.ObjectiveWe sought to establish the HRM parameters indicative of functioning fundoplications, and whether HRM could distinguish them from tight or defective ones.MethodsThe study involved patients with GERD who underwent laparoscopic Nissen (LN) or Toupet (LT) fundoplication between 2010 and 2022. HRM and 24‐h pH monitoring were performed before and 6 months after surgery. The study population was divided into 5 groups: LN and LT patients with normal 24h‐pH findings (LNpH‐ and LTpH‐, respectively); LN and LT patients with pathological 24h‐pH findings (LNpH+ and LTpH + groups, respectively); and patients with a postoperative dysphagia intensity score >2 (Dysphagia group). The novel Hiatal Morphology (HM) classification was applied, envisaging 3 different subtypes: HM1 (normal), HM2 (intrathoracic fundoplication), and HM3 (slipped fundoplication).ResultsAmong the 132 patients recruited during the study period, 46 were in the LNpH‐ group, 51 in the LTpH‐ group, 15 in the LNpH + group, 7 in the LTpH + group, and 5 in the Dysphagia group. In multivariate analysis, postoperative abdominal lower esophageal sphincter length (p = 0.001) and HM2 (p < 0.001) were both independently associated with surgical failure. Integrated relaxation pressure was significantly higher in the Dysphagia group than in the LNpH‐ group.ConclusionThis study generated reference HRM values for an effective LF, and confirms that using HRM to assess the neo‐sphincter and HM improves the clinical assessment in cases of symptom recurrence.

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Practice guidelines on the use of esophageal manometry – A GISMAD-SIGE-AIGO medical position statement

Cited by 92 publications

References 134 publications

Fragmented and failed swallows on esophageal high‐resolution manometry associate with abnormal reflux burden better than weak swallows

Fragmented and failed swallows on esophageal high‐resolution manometry associate with abnormal reflux burden better than weak swallows

Cómo realizar e interpretar una manometría esofágica de alta resolución usando la clasificación de Chicago 3.0

Manometric identikit of a functioning and effective fundoplication for gastroesophageal reflux disease in the high‐resolution manometry ERA

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